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Eye Health Center

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You Might See Better in Your Eye Doctor's Office

Research suggests older adults may have poorer vision at home, mostly because of lower lighting


The same dynamic was observed with near vision, the researchers said. More than one-fifth of patients experienced better results at the doctor's office when trying to read two or more lines of text.

Bhorade and her associates determined that lighting was the key factor behind the difference. Home lighting was three to four times less bright than in a clinical setting, on average.

"Not all older adults, however, may benefit from increased lighting," Bhorade said. "Therefore, to optimize lighting conditions in the home, we recommend an individualized in-home assessment by an occupational therapist, or a referral to a low-vision rehabilitation specialist."

Dr. Alfred Sommer, a professor of ophthalmology at the Bloomberg School of Public Health at Johns Hopkins University, said the study highlights the broader issue of understanding the real-world limitations of people with vision issues.

"This is a real issue," he said. "The ophthalmologist's office is not the world we live in. It's a very artificial situation, in which vision is tested in a very dark room but with very high contrast letters. And even that's only looking at one measure of vision, without regard to other possible [eye] issues."

"It's no surprise that when people are in their home setting, under ambient conditions, everything is a little bit grayer and not so intense," Sommer said. "The question is whether that difference has a functional impact. Can people easily navigate through their world and function in society?"

"This is a whole new science that is now coming into play -- the effort to develop ways to test for real-life conditions so we can improve vision in a way that's really meaningful to patients," Sommer said.

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